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ORIGINAL ARTICLE

HIV Heterosexual Sexual Risk From Injecting Drug Users Among HIV-Seronegative Noninjecting Heroin Users

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Pages 208-217 | Published online: 08 Feb 2011
 

Abstract

Noninjecting heroin users (NIUs) were recruited in New York City during 1996–2003. Cumulative logistic regression was used to analyze the correlates of HIV sexual risk from injecting drug users (IDUs) among HIV seronegative NIUs engaging in heterosexual vaginal or anal sex in the past 30 days (N = 347). Participants were 67% male and 70% African American or Latino, with a mean age of 32.6 years. Hierarchical categories of IDU partner sexual risk included (1) no unprotected sex and no IDU sex partners (21%), (2) unprotected sex but not with IDUs (55%), (3) IDU sex partners but no unprotected sex with them (6%), and (4) unprotected sex with IDUs (17%). Independent correlates (p < .05) of HIV sexual risk from IDU partners included female versus male gender (adjusted odds ratio [AOR] = 2.01), ex-IDU versus never IDU (AOR = 1.90), and lower versus higher perceived social distance from IDUs (AOR = 1.60). Interventions should target female NIUs, ex-IDUs, and NIU members of IDU social and sexual networks. The study's limitations are noted.

THE AUTHORS

Alan Neaigus, Ph.D. (sociology), is Director of Research in the HIV Epidemiology Program at the NYC Department of Health and Mental Hygiene. Formerly, he was Deputy Director and Principal Investigator in the Institute for International Research on Youth at Risk at National Development and Research Institutes. He is also an Adjunct Associate Professor in the Department of Epidemiology at the Mailman School of Public Health, Columbia University, and a Senior Research Scientist at the Center for Drug and Social Policy Research at the University of Houston. Since 1988, he has conducted research on HIV/AIDS and other blood-borne infections and STIs among IDUs and noninjecting drug users in NYC, Newark (New Jersey), and other locations and on the factors associated with the initiation and resumption of injecting among noninjecting drug users. His international research has included studies on the behavioral and network risks for HIV, hepatitis, and STIs among drug injectors in Budapest, Hungary, and on the social context of injecting drug use and HIV risk in Marseilles, France. His current research interests focus on the influence of social networks and social structure on HIV risk and infection in at-risk urban populations. He has authored or coauthored numerous publications in peer-reviewed journals.

Maureen Miller, Ph.D. (epidemiology), is a Columbia University–educated senior academic epidemiologist with documented expertise in both quantitative and qualitative methodologies. She has been involved in applied infectious disease prevention research, programming, and policy since 1990, has published a number of theoretical and research articles in peer-reviewed scientific journals, and has conducted innovative research in resource-poor settings. While a full-time professor at Columbia University, she established Bed Stuy West Community Studies, a successful community–academic health research partnership in the largest Black community in North America. In addition to conducting research, Dr. Miller consults extensively with governmental and non- and intergovernmental organizations around the world, as well as with academic institutions and corporate clients. Her completed projects range from the evaluation of an urban syringe exchange program that resulted in national program expansion to the development of an analytic framework to evaluate international health programs in terms of gender-responsive activities to the creation of a strategic 5-year HIV prevention plan for a major US city.

V. Anna Gyarmathy, Ph.D., M.S., completed her Ph.D. in clinical psychology with a concentration in behavioral sciences at Semmelweis University in Budapest, Hungary, and her postdoctoral training at the Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University. She is a scientific writer at the European Monitoring Centre for Drugs and Drug Addiction in Lisbon, Portugal. She has worked in the field of public health research since 1994. Her research has concentrated on the epidemiology and prevention of HIV/AIDS and hepatitis infections among disadvantaged and at-risk populations (such as IDUs and noninjecting drug users) in the European Union, the United States, and Russia. Her recent work has focused on social and risk networks. Much of her research has been published in Medline-referenced journals and presented at national and international conferences. She also regularly reviews manuscripts for several public health journals.

Samuel R. Friedman, Ph.D. (sociology), is a Senior Research Fellow in the Institute for AIDS Research at National Development and Research Institutes, Inc., and the Director of the Interdisciplinary Theoretical Synthesis Core at the Center for Drug Use and HIV Research at multiple institutions in NYC. (He is also a prior Director of the Research Methods Core at the Center for Drug Use and HIV Research.) His other appointments include Senior Research Associate at the Department of Epidemiology, Johns Hopkins University. Dr. Friedman is an author of over 380 publications on HIV, STI, and drug use epidemiology and prevention. His recent research projects have included the following: a review paper (Friedman, Kippax, Phaswana-Mafuya, Rossi, & Newman, Citation2006) on the social research needs of the AIDS field; a study of social factors, social networks, and HIV, STI, and other blood-borne viruses among youth and drug injectors in a high-risk community; research on the impact of economic and political crises on HIV risk in Buenos Aires; a study of how some long-term drug injectors remain uninfected with HIV and HCV (i.e., how they stay safe); a study of socioeconomic and policy predictors of the extent of injection drug use, of HIV epidemics, and of HIV prevention efforts in US metropolitan areas; and research on why women injectors who have sex with women are at enhanced risk for HIV and other infections. He has been engaged in many international collaborative projects with the World Health Organization's MultiCentre Study of Drugs and HIV and with researchers in Argentina, Brazil, Spain, Australia, Canada, the Netherlands, and other countries. He has also written on international HIV topics such as war and HIV, sociopolitical transitions and HIV, and drug users’ organizations (user groups) as actors globally against HIV. He is Associate Editor for Social Science of the International Journal of Drug Policy and is or has recently been on the editorial boards of AIDS; Journal of Acquired Immune Deficiency Syndromes; AIDScience, a Web venture for the American Association for the Advancement of Science; AIDS Education and Prevention; The Drug and Alcohol Professional; and Harm Reduction Journal. He is a published poet who often presents readings at conferences on HIV/AIDS and/or on preventing drug-use-related harm.

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